Sign up for our newsletter

Fibromyalgia is a complex medical condition that circles around pain, fatigue, pressure, and other symptoms. It is not well understood, but it appears to affect the central nervous system.

Fibromyalgia is often a condition that is also closely related or affected by other conditions such as depression, post-traumatic stress disorder, and anxiety. Not all individuals experience the entire range of symptoms.

It is seen in women almost 9 times for every 1 times it is seen in men. This condition remains to be elusive in defining a cause or acceptability throughout the medical world.

The belief by some health care providers is that there is a lack of abnormalities on physical exam and there are no objective diagnostic tests that show an abnormality.

It has been recognized as a diagnosable disorder by the National Institute of Health and the American College of Rheumatology. This is a major issue of Women’s Health

Symptoms

*** Pain is often in many locations therefore the diagnosis is often made after several different complaints of body pain with normal X-ray, MRI, and blood work examinations

Causes

– Currently the cause of fibromyalgia is unknown.
– Theories range from a mental health initiated pain change.
– To lower pain threshold because of increased brain sensitivity.
– Stress may be a cause or at least a precipitating factor.
– But it is unclear why it affects some people and not others.
– Lack of sleep may also be a risk factor for this condition.

Diagnosis

– No single test can help diagnosis a patient.
– The debate about a proper diagnosis procedure is underway.
– Lab tests are often normal.
– Usually diagnosis occurs after many other problems have been eliminated as possibilities.
– Consideration for age, gender, symptoms, location, medical history, and other factors should be given.

Additional consideration:

– Widespread pain lasting for more than 3 months affecting both sides of the body and above and below the waist.
– Tender points – patient must feel pain in 11 of the 18 tender points.

Treatment

– There is no universally accepted treatment.
– Symptoms can be different in many cases.
– Behavioral therapies are designed to help with mental health, fatigue, and inactivity.
– Exercise if often helpful, though this is light exercise such as walking or pool use for many patients.

Physical Treatment

– Exercise and fitness helps reduce pain, fatigue, and it improves overall sleep and health
– Strong evidence that cardiovascular exercise is effective in some patients

Medications

1.) Pregabalin – approved for use in Fibromyalgia in June 2007
2.) Duloxetine – approved in 2008
3.) Milnacipran – approved in 2009

Pregabalin and Duloxetine can help reduce pain in some patients

Antidepressants

– Quality of life were improved in patients with fibromyalgia by taking something for depression
– Sleep, fatigue, depression, and other symptoms were improved.

– This medication is a long acting pain medication
– Is moderately effective in treating fibromyalgia

Neurontin (gabapentin)

– An atypical seizure medication that is also used to help tingling and nerve problems.
– Is also used in some diabetics to help with Neuropathy
– Is approved for neuropathic pain but is not approved for fibromyalgia
– Is occasionally used for fibromyalgia

Lyrica (pregabalin)

– Is used for treatment of nerve pain in Diabetics
– Some benefit is seen in a small population of patients with fibromyalgia
– Is not approved for fibromyalgia
– Is occasionally used for fibromyalgia

Mirapex and Requip

– Has some improvement
– Many side effects make these medications more of a concern than a treatment option

Muscle Relaxers

– Flexeril (Cyclobenzaprine) is occasionally used to help muscle pains felt by those with fibromyalgia.
– It has been studied for this use
– Has mild improvement overall
– Tizanidine is another muscle relaxer
– Is typically used less often than Flexeril

Opioids

– These are stronger pain medications called Narcotics
– This medication should be the last tried medication for pain
– It is not often a good option unless all other avenues have been evaluated
– The risk for abuse often outweighs the benefits gained.
– Addiction is another concern
– No actual studies have shown benefit of opioids and fibromyalgia
– Symptoms may actually worsen when taking